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 Zambia HIV National Guidelines
 


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 Guide Editors
 Editor In Chief
    Joel E. Gallant, MD, MPH

Pharmacology Editor
    Paul Pham, PharmD, BCPS

Zambia Guideline Team
   Peter Mwaba MMed PhD FRCP
   Alywn Mwinga MMed
   Isaac Zulu MMed MPH
   Velepie Mtonga MMed
   Albert Mwango MBChB
   Jabbin Mulwanda MMed FCS
 

 

 

Drugs>Antimicrobial Agents>
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Ethionamide

Pham P and Bartlett JG
10-03-2008

Zambia Specific Information

  • Available formulation in Zambia: Tablet: 125 mg; 250 mg.
  • MDRTB standardized regimen: ethionamide 500 mg/d (<50 kg); 750 mg (>50 kg) plus kanamycin, pyrazinamide, ofloxacin, and ethambutol x 4 month, then based on culture conversion and sensitivity, continue with ethionamide, ofloxacin, and ethambutol for 12-18 months.

REFERENCES

Zambia Information Author: Paul A. Pham, Pharm. D.

INDICATIONS

FDA

  • Tuberculosis (in patients w/ active M. tuberculosis resistant to isoniazid or rifampin, or when there is intolerance to other drugs)

FORMS

brand 
name
 
generic 
Mfg 
brand 
forms
 
cost* 
Trecator-SCEthionamide Wyethoral
tablet
250mg
$3.09

*Prices represent cost per unit specified and are representative of "Average Wholesale Price" (AWP). AWP Prices were obtained and gathered by Lakshmi Vasist Pharm D using the Red Book, manufacturer's information, and the McKesson database.

^Dosage is indicated in mg unless otherwise noted.

USUAL ADULT DOSING

15-20mg/kg/day (max 1g/day), usually 500-750mg divided q24, q12h or q8h administered w/ food or at bedtime.

RENAL DOSING

DOSING FOR GLOMERULAR FILTRATION OF 50-80

Usual dose.

DOSING FOR GLOMERULAR FILTRATION OF 10-50

250-500mg once daily with clearance <30ml/min.

DOSING FOR GLOMERULAR FILTRATION OF <10 ML/MIN

250-500mg once daily.

DOSING IN HEMODIALYSIS

250-500mg once daily.

DOSING IN PERITONEAL DIALYSIS

Usual dose.

DOSING IN HEMOFILTRATION

No data.

ADVERSE DRUG REACTIONS

COMMON

  • Severe GI intolerance: nausea, vomiting, metallic taste, anorexia, and abdominal pain
OCCASIONAL

  • Allergic reactions
  • Reversible hepatitis (2%), jaundice (1-3%)--monitor LFTs q2-4 wks
  • Endocrine: gynecomastia; menstrual irregularities
  • Neurotoxicity (prevented w/ pyridoxine)
  • Diarrhea
  • CNS: depression, anxiety, psychosis, dizziness, visual disturbances
  • Orthostatic hypotension
RARE

  • Optic neuritis
  • Gouty arthritis
  • Hypothyroidism
  • Impotence
  • Rash

DRUG INTERACTIONS

Cycloserine: potential increase incidence of neurotoxicity. Avoid concurrent administration, especially in patients with a history of seizures.

SPECTRUM

Detailed Spectrum of Activity

PHARMACOLOGY

Pharmacology

COMMENTS

2nd line oral agent for TB (MDRTB and XDRTB) and leprosy. Severe GI side effects and orthostatic hypotension may limit its use.

REFERENCES

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